What is included in postprocedure care following intrauterine device (IUD) insertion?

Updated: Nov 29, 2018
  • Author: Sarah Hagood Milton, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Following IUD insertion, patients should schedule a follow-up visit in approximately 4 weeks. At this visit, any problems can be discussed and an examination should be performed to confirm the IUD strings are visible extending from the cervical os. Absence of the IUD strings during this examination is concern for migration of the IUD, possibly related to unrecognized uterine perforation, and warrants further evaluation.

No antibiotic prophylaxis is indicated for IUD insertion. Multiple studies have examined the effect of antibiotic prophylaxis on postinsertion infection in low-risk patients. Antibiotic prophylaxis has been convincingly shown to have no effect on the incidence of postinsertion pelvic inflammatory disease. [32, 33, 34]

Risk of infection is greatest the first 20 days after insertion, suggesting the etiology of infection is contamination at time of insertion rather than the IUD itself. [35, 23] Accordingly, prevention of infection is best accomplished by careful screening for infection by history and physical examination prior to and at the time of IUD insertion.


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